By Maureen Gilmer, IU Health senior journalist, firstname.lastname@example.org
Eight-year-old Lucas Reinoehl might be in the hospital, but he’s living his best life while there.
The second-grader has been playing video games and organizing his Pokemon trading cards pretty much nonstop since he arrived at Riley Hospital for Children from his home in Ohio three weeks ago.
In preparation for spinal surgery, Lucas is undergoing halo traction for several weeks, a method of gently stretching and straightening his severely curved spine. Halo-gravity traction pulls the head and spine upward carefully, applying a slow stretch to the spine. Doctors do this by attaching a metal ring that surrounds the head to a pulley system with weight gradually added over time.
On March 2, Lucas will head into the operating room, where orthopedic surgeons Dr. Tyler Christman and Dr. Ryan Fitzgerald will implant growing rods to correct his spine over time.
It sounds like a lot for anyone to deal with, but Lucas is unfazed. After a day or two of getting used to the traction device, he settled in nicely in his eighth-floor Riley room decorated with his favorite posters and stuffed animals.
“We are putting more than 20 pounds of weight through his spine now, and he doesn’t seem to be fazed by it,” Dr. Christman said.
The device comes off for showering, dressing and physical therapy, but otherwise Lucas wears it all the time – in bed and in a wheelchair.
His parents, Tyler and Sarah Reinoehl, say he’s handling this ordeal better than they are.
Lucas has been a Riley kid since he was about 10 months old. His parents noticed he seemed to sit a little crooked, and X-rays revealed a significant curve in his spine. They were referred to Riley, and Lucas was fitted with his first upper body cast to stabilize his spine when he was 15 months old. He would go on to wear 15 more casts over the next seven years.
“The first casting was very hard,” Sarah said. “We didn’t know how he would react, but he has been amazing through the whole process. I think it’s been harder on my husband and me.”
Tyler and Sarah spend alternate weeks at Riley with their only child, whom Tyler describes as “a high-spirited, cheerful little boy.”
“He has his moments,” Tyler said, “like when he doesn’t want to take his medicine, but what 8-year-old does? Otherwise, he’s taking it like a champ, better than I would.”
Father and son spend their days playing video games together and enjoying precious time that they wouldn’t ordinarily have at home.
“For me, it was an adjustment to be in the hospital 24-7, but we’re doing good,” said Tyler, who sleeps on the couch in his son’s room. “The couch needs to be about 3 inches longer and 3 inches wider. Other than that, it’s perfect,” he laughed.
Both parents can’t say enough about the Riley team during their current stay and their visits over the years.
“Everybody at this hospital has been great,” Tyler said. “It’s been a long journey, but we’ve never had a bad experience. And the best thing is the results.”
Lucas has severe kyphoscoliosis, an abnormal curvature of the spine, in addition to cleidocranial dysplasia, a genetic condition that affects teeth and bones, often including the skull, face, spine, collarbones and legs.
While casting can be curative for some kids with early onset scoliosis or infantile scoliosis, Lucas’ case is much more serious, Dr. Christman said. Casting helped keep the curve from getting worse, but it never got better. So traction was the next step, followed by surgery.
“If we were to take him to the operating room without halo traction, he’d be at greater risk for nerve or spinal cord injury,” the surgeon said. “The spine only likes to stretch so far. By doing this halo gravity traction, we can gently stretch his spine pre-operatively.”
After the 6- to 8-inch magnetic rods are placed in Lucas’ spine, he will heal for a few days before going home. He will return to Riley every three to four months to have X-rays, then the MAGEC rods will be lengthened a few millimeters in clinic using an electromagnet, so no incision is required.
Lucas, who is about 42 inches tall and weighs 48 pounds, might even grow a smidge during surgery.
With large curves, kids do gain some height as the spine is gently stretched, Dr. Christman said.
“It’s not uncommon for teens to gain an inch or two during surgery. That’s one of the questions kids ask,” he said. “How much taller will I be?”
Lucas is more concerned about being able to go swimming and having fun with his cousins, his parents say, activities that were limited by the casts.
Meanwhile, he continues to charm the nurses, doctors and therapists, even persuading some of them to play Pokemon, Minecraft and Fortnite with him. Count Dr. Christman among that bunch.
“I have played some games with him,” the surgeon said with a laugh. “He has moved in and gotten very comfortable in his room. I look forward to rounding and stopping in, saying hi and playing some games.”
Sarah appreciates the relationship Dr. Christman has with Lucas and the family.
“He has been so great,” she said. “It makes me feel more at ease that we have a doctor who listens, answers all of my questions and is willing to play with our son.”
With a kid like Lucas, it’s easy, Dr. Christman said.
“Lucas has been a patient of mine for a long time. We have a great relationship. I’m honored to take care of him and to have his parents put that trust in us.”
As Lucas continues to grow, the Riley team will keep up with that growth using the magnetic rods, Dr. Christman said. Eventually, he will require a formal fusion – removing the rods and fusing the spine with traditional screws and rods – once he is finished growing.
“It’s been a great experience to treat Lucas and to learn from him,” Dr. Christman said. “His positive attitude is contagious, and he’s just a fun kid. He has been through so much with casting and now with traction, but he lives fearlessly.”
Photos submitted and by Mike Dickbernd, IU Health visual journalist, email@example.com